For over a decade, Connie Sigler’s lakefront home has been filled with strangers who turn into family.
Connie and her husband, Jack, currently have three people at their licensed adult foster care home, which they call “Home Away from Home,” which is licensed through the State of Michigan. Two residents are veterans enrolled in health care with the Veterans Health Administration.
“Jack does a lot of the cooking and cleaning, but we both do a little bit of everything,” she said. “We like to have [the residents] come and eat with us, or we eat with them. We also have to get their medications together because they’re not able to do that.”
Connie is a former preschool teacher and nurse’s aide, while Jack was a paramedic for 30 years.
“The veterans have lived through a lot of things, and they have stories to tell us,” Sigler said. “They really aren’t much different than the preschoolers I used to work with — just older.”
Two of her residents generally keep to themselves, while the third has been in the home, about two miles from the Michigan and Ohio border, since 2017.
“He’s just like family,” she said. “He will watch ‘Jeopardy’ with us and answer the questions before the contestants. He’s always doing crossword puzzles — he goes through those books so fast.”
According to the U.S. Department of Veterans Affairs, the Medical Foster Home program supports veterans who can no longer live independently due to “serious chronic disabling conditions that meet nursing home level standards” but prefer an alternative to an institutionalized setting for long-term care.
In 1999, two social workers at the Little Rock VA Medical Center piloted the first Medical Foster Home program. Today, the program is administered at 156 VA medical centers, serving over 700 veterans in those regions. The goal is to have the program available at every VA medical center nationwide by 2025. In Detroit, the John D. Dingell VA Medical Center is a new program looking to recruit caregivers who are interested in owning a Medical Foster Home. Saginaw is also looking to get up and running.
In Michigan, the program is available at the VA medical centers in Ann Arbor and Battle Creek. Since launching in 2010, 180 veterans combined have used the program. Currently, Ann Arbor’s six Medical Foster Homes serve seven veterans, while seven homes through Battle Creek serve 15.
The program requires caregivers to have no more than three residents in the home. Each veteran is assigned a Home-Based Primary Care Team, which includes a nurse case manager, social worker, pharmacist, and a primary care physician — among other specialists based on a veteran’s needs.
“I go into the home unannounced once a month and visit with the veterans,” said Melissa Laird, Medical Foster Home program coordinator for the VA Ann Arbor Healthcare System. “I make sure they are stable and getting the things that they need. I also assess the caregivers’ needs and provide caregiver relief, whether it be identifying signs of burnout or whatever is needed for that person to remain successful in their role.”
The program also offers ongoing caregiver support and 30 respite days each year.
“It’s not just about the veteran — the VA will say, ‘Whatever you need, let us know,’” Sigler said.
Potential caregivers undergo a background check and home inspection, Laird said. Once approved, caregivers are required to complete biannual training sessions.
For veterans in need of long-term care, the transition from living independently to a Medical Foster Home comes with its own set of challenges.
“A lot of them are losing their homes, they’re losing their cars…they feel like they’re losing their family,” Sigler said. “There’s a lot of anxiety when everybody first gets here, and so I try to talk to them about those issues. It usually takes a good six months for them to get comfortable being here.”
Another adjustment for veterans is having 24/7 care and supervision. For example, for some, going for a walk isn’t permitted without being accompanied by a caregiver.
However, the cost of living in a Medical Foster Home is typically less than that of a nursing home, Laird said, ranging from about $3,000 to $4,000 per month for the homes she oversees. The VA provides caregivers help with how to best determine a price range, and once that is settled, a private contract is created between the caregiver and veteran.
The Joseph Maxwell Cleland and Robert Joseph Dole Memorial Veterans Benefits and Health Care Improvement Act of 2022, also known as the Cleland-Dole Act, will eventually make it possible for Medical Foster Homes to be a paid benefit for highly service-connected veterans, Laird said. The act was designed to expand veteran services for mental health, long-term care, telehealth and homelessness over the next five years.
Aside from financial benefits, a 2019 study by VA researcher and physician Cari Levy found better survival rates among veterans in Medical Foster Homes compared to veterans residing in traditional nursing homes with similar demographics and health problems. Levy’s qualitative studies involving interviews with veterans showed additional benefits, such as feeling like they were part of the caregiver’s family.
Sigler has four children and 12 grandchildren — and she always includes residents in family dinners and birthday celebrations.
While ultimately rewarding, the job of a Medical Foster Home caregiver comes with ups and downs. “You have to be flexible, patient and understanding,” she says. “You also can’t save them all, even when you really want to.”
To become a Medical Foster Home (MFH) Caregiver, explore the Medical Foster Home Checklist and contact your local MFH Coordinator.
Ann Arbor
Melissa Lard, LMSW
734-905-4853
Battle Creek
Julie M. Anderson, LMSW
269-529-0105
Detroit
The John D. Dingell VA Medical Center in Detroit is a new Medical Foster Home program looking to recruit caregivers who are interested in owning a Medical Foster Home. Call the Detroit coordinator at 313-318-7219.
Saginaw
The Aleda E. Lutz VA Medical Center in Saginaw is a new program looking to recruit caregivers who are interested in owning a Medical Foster Home. Call the coordinator at 989-497-2500 x 13049.
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